Persistent Progressive Peri-Auricular Nodules with Lymphadenopathy

Area of Science:

• Immunology
• Dermatology
• Pathology

Background:

• Kimura's disease (KD) is a rare, benign chronic inflammatory disorder of unknown cause.
• It predominantly affects young Asian males, presenting with painless head and neck nodules, lymphadenopathy, eosinophilia, and elevated IgE.
• Distinguishing KD from malignancies and angiolymphoid hyperplasia with eosinophilia is diagnostically challenging.

Purpose of the Study:

• To report a case of Kimura's disease in an 18-year-old male.
• To highlight the diagnostic challenges and clinical presentation of KD.
• To emphasize the importance of accurate diagnosis for appropriate treatment.

Main Methods:

• Clinical presentation of an 18-year-old male with persistent bilateral retroauricular and left cheek swellings.
• Histopathological examination of a peri-auricular lesion.
• Laboratory tests for peripheral eosinophilia and serum IgE levels.
• Imaging studies including cervical lymphadenopathy and parotid gland assessment.

Main Results:

• Histopathology revealed hyperplastic lymphoid follicles, eosinophilic infiltrates, and deposits.
• Laboratory results showed marked eosinophilia and elevated IgE.
• Imaging confirmed bilateral cervical lymphadenopathy and parotid gland involvement.
• The patient responded well to oral corticosteroids.

Conclusions:

• The case highlights the diagnostic complexities of Kimura's disease.
• Prompt recognition is crucial to avoid misdiagnosis, particularly differentiating from malignancies.
• Corticosteroid therapy proved effective in managing the patient's symptoms.